Individual provider Active NPI

Joy Welcker, PH.D.

  • Professional Counselor
  • Statesboro, GA
National Provider Identifier
1912286089
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
9526 Issued in GA
Practice address
124 Savannah Ave Ste 1C
Statesboro, GA 30458-7149
Phone
(912) 481-2652
Fax
(912) 225-3770
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 4747 NC
Psychologist 103T00000X 4747 NC
Professional Counselor 101YP2500X 9526 GA Primary

Addresses

Primary practice location

124 Savannah Ave Ste 1C
Statesboro, GA 30458-7149

Mailing address

PO Box 2872
Statesboro, GA 30459-2872
Phone (912) 481-2652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4747NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Brains, LLC CurrentSince Mar 19, 2023 Accepting new patients
Child Neurobehavioral Center for Health & Wellness, PC Clinical Neuropsychologist Past Accepting new patients

Locations

124 Savannah Ave
Ste 1C
Statesboro, GA 30458
Phone (912) 481-2652

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1912286089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2872",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304592872",
            "telephone_number": "912-481-2652",
            "fax_number": "912-225-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SAVANNAH AVE STE 1C",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304587149",
            "telephone_number": "912-481-2652",
            "fax_number": "912-225-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCKER",
        "first_name": "JOY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NC",
            "license": "4747",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4747",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "9526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.